Postoperative Pain Management
Mitra SP[1], Aziz L[2], Iqbal KM[3]
Abstract:
The Postoperative pain issue still remains unsolved as various modalities keep presenting its limitations. The consequences of postoperative pain, which is acute in nature, include clinical, economic, and patient-reported outcomes; thus, improving the treatment of postoperative pain has the potential to improve health care from a broad perspective. Opioids remain the cornerstone of treatment of postoperative pain. Multimodal analgesia also has the potential to improve the pharmacotherapy of postoperative pain.
Among the various modalities we have limitations to use PCA, continuous epidural Analgesia, continuous intrathecal analgesia in various part of the country due lack of adequate manpower, equipment and cost effectiveness. Sometimes the right drugs like clonidine, levobupivacaine, preservative free morphine, pethidine and ketamine not available. Only few develop centers can use some of the modalities. Even among the used sources and technologies we forgot to consider organ failure and extreme age conditions due to lack of postoperative pain protocol. As a part of ethical issue, attention increasing towards the patients satisfaction on postoperative pain management in western world and we are not very far from the problems.
To face the upcoming challenge we need to develop the manpower and we can prepare ourselves by accustoming with pain pathophysiology, useable modalities, refreshers training and finally developing a protocol in the particular station consistent with available resources.
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[1] Dr Shyama Prosad Mitra, Sr. Registrar, Anaesthesia, ICU & Pain Medicine, Apollo Hospitals Dhaka
[2] Dr Lutful Aziz, Consultant, Anaesthesia, ICU & Pain Medicine, Apollo Hospitals Dhaka.
[3] Prof Kazi M Iqbal, Consultant & Coordinator, Anaesthesia, ICU & Pain Medicine, Apollo Hospitals Dhaka